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Pharm 1 > 09. Cholinergic and Anticholinergic Drugs > Flashcards

09. Cholinergic and Anticholinergic Drugs Flashcards

1
Q

Cholinergics vs. Anti-cholinergics: HEART RATE

A

Cholinergics: Decreased HR, Vasodilitation

Anti-cholinergics: Increased HR

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2
Q

Cholinergics vs. Anti-cholinergics: BRONCHUS

A 
Cholinergics:
- Bronchoconstriction
- Increased secretions
- Increased salivation
Anti-cholinergics:
- Decreased secretions
- Decreased salvation
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3
Q

Cholinergics vs. Anti-cholinergics: PUPILS

A

Cholinergics: Contriction

Anti-cholinergics: Dilation

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4
Q

Cholinergics vs. Anti-cholinergics: GI

A

Cholinergics:
- Increased motility, increased secretions
Anti-cholinergics:
- Decreased motility, decreased secretions

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5
Q

Cholinergics vs. Anti-cholinergics: SWEATING

A

Cholinergics: Increased sweating

Anti-cholinergics: Decreased sweating

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6
Q

Cholinergics vs. Anti-cholinergics: UA

A

Cholinergics: Voiding (due to relaxation of sphincter)

Anti-cholinergics: Retention

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7
Q

Cholinergics vs. Anti-cholinergics: CNS

A

Cholinergics: ~

Anti-cholinergics: Stimulation of CNS –> Depression in large doses

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8
Q

Cholinergics (4) vs. Anti-cholinergics (5): USES

A

Cholinergics: Limited, but varied:

  • UA retention
  • Dx & Tx of MG
  • Alzheimer’s
  • Glaucoma

Anti-cholinergics:

  • Antipasmodics
  • Tx Parkinson’s
  • Asthma
  • Bradycardia
  • Pre-op: Decreased vagal stimulation
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9
Q

Parasympathominetic refers to the ______ classification of drugs, which has the same effect as _______ the PSNS.

A

Cholinergic

Stimulating

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10
Q

Cholinergic prototype

A

Neostigmine (Prostigmine)

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11
Q

Parasympatholitic refers to the _______ classification of drugs, which has the same effect as _____ the PSNS.

A

Anti-cholinergic

Inhibiting

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12
Q

Anti-cholinergic prototype

A

Atropine

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13
Q

What effect does neostigmine have on nicotinic receptors?

A
  • In motor nerves and skeletal muscles –> Muscle contraction
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14
Q

What effect does neostigmine have on muscarinic receptors?

A
  • In most internal organs –> Increased secretions
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15
Q

Cholinergic v. Anti-cholinergic: SALIVARY GLAND

A

Cholinergic: Increased salivation

Anti-cholinergic:

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16
Q

Neostigmine mimics the action of ______ AND inhibits ints destruction.

A

Acetylcholine

17
Q

Name four drugs that mimic the action of Acetylcholine.

A
  • Neostigmine
  • Urecholine
  • Reglan
  • Pilocarpine
18
Q

Six clinical uses of neostigmine.

A
  • Bladder atony. (Helps relax the sphincter and allow pt to urinate)
  • Dx & Tx of Myasthenia Gravis
  • Anedote (to depolarizing neurotransmitter blockers in the OR)
  • Glaucoma (causes miosis, which decreases pressure in the eye)
  • Alzheimer’s
  • GI tract atony
19
Q

What is Myasthenia Gravis? What treats it?

A

Autoimmune neuromuscular disease. Neostigmine.

20
Q

5 common side effects of Neostigmine

A
  • *Exacerbation of intended effects:
  • Salivation
  • Diaphoresis (sweating)
  • Abdominal camping
  • N/V
  • Diarrhea
21
Q

3 serious ADEs of Neostigmine:

A
  • Bradycardia
  • Hypotension
  • Shock
22
Q

What is a cholinergic crisis?

A
  • Too much anticholinesterace (cholinergic drug)
23
Q

What is a Myasthenia crisis?

A
  • Dose to control Myasthenia Gravis is too small; pt needs larger dose.
24
Q
  • How do you tell the difference between a cholinergic crisis and a Myasthenia crisis?
  • …in a crisis?
A
  • Order a dose of endrophonium (Tensilon)

- Just order an antidote - Atropine.

25
Q

Atropine blocks the action of _______

A

Acetylcholine

26
Q

Anti-cholinergic prototype

A

Atropine

27
Q

Atropine ADEs

  • Common (5)
  • Serious (2)
A

COMMON

  • Blurred vision
  • Dry mouth
  • Constipation
  • Urinary retention
  • Photophobia

SERIOUS

  • Cardiac arrhythmias
  • Tachyarrhythmias
28
Q

6 Contraindications of Atropine

A
  • Prostatic hypertrophy
  • Glaucoma
  • Tachy arrhythmias
  • Acute MI
  • Congestive Heart Failure
  • Myasthenia Gravis (although atropine is an anecdote if pt is over-treated for MG with Neostigmine)
29
Q

In a Myasthenic crisis, ________ is an anecdote for too much _______.

A

Atropine, neostigmine.

Pharm 1 (6 decks)

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